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can highlight, for example, positive examples of primary care provision such as

Airedale Hospital and Royal Free Hospital in London (see section 4.3). Fostering

cross sector understanding is critical to bring about a shift in health and care

services towards self-care and prevention.

We welcome Monitor's new guidance which will help patients receive more

joined-up care. A core principle of this new guidance is that NHS providers

should work effectively with other health and social care organisations locally

in order to identify and improve ways of delivering person-centred, coordinated

care for patients. For the first time NHS providers could lose their licence if they

are seen to block the delivery of integrated care when it can benefit patients. The

guidance also states that if NHS providers must 1) work with commissioners to

with commissioners to identify better coordination of services, 2) discuss shared

care plans for patients, or 3) avoid unnecessary delays in the handover of patient

records. Failure on any of these grounds will lead them liable to action from the


We also support Demos' recommendation in their 'Commission on Residential

Care' report that the Government should sponsor grants to stimulate innovation

in the housing with care sector to make it "more personalised, more connected

and more preventative" by increasing wellbeing, reducing unnecessary hospital

admissions and helping people to stay in their own homes.127

Recommendation: Fast track a practical and NHS-focused What

Works Centre for Integration, building on the strengths of existing

organisations, staffed by national health, GP and council policy

professionals (maintaining tri-partite approach).

Impact: This would:

• Tackle the perceived shortfall in step down care.

• Improve the communication and culture differences between health and

social care providers.

• Better the co-ordination of local services.

4.9 National leadership - Introducing a Minister for Older


Despite repeated public acknowledgement of the potency of the demographic

change we are experiencing, and the scale of the concomitant challenge that

the country faces, it is revealing that our survey found that 85 per cent of health

practitioners felt that the health and social care aspects of ageing are not

sufficiently well understood in the corridors of Westminster and Whitehall. We

believe this is because cross-cutting issues like ageing are all too easily lost in the

cracks between Government Departments.

Therefore we propose the introduction of a Minister for Older People. But not just

a title, this needs to be a post with the power to influence policy. The key point

here is that it is cross departmental so as to reach beyond existing silos and make

things happen. This reform would be cost neutral as we are not advocating the

creation of a new ministry but instead to expand the remit of a current Secretary

of State to include the post.

In addition to this, taking on board the concerns of local health leaders, NHS

England and Public Health England need to consider when and where leadership

and guidance is appropriate… The view of several Directors of Public Health

was that national leadership bodies "need to take a back seat." Longer term,

126 Monitor, "Monitor guidance

to help patients receive more

joined-up care" (14 January


127 Demos, Commission on

residential care (2014)


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